Top 20 Selling Cancer Drugs 2025

The field of cancer treatment has always been an important market for major pharmaceutical giants to compete for. In 2024, its global market size reached a new high. The top 20 best-selling tumor drugs set a new record with a total sales of US$147.4 billion, an increase of US$15.1 billion over the previous year.

In the TOP20 list, the top three drugs are all monoclonal antibodies, namely Merck's Keytruda (pembrolizumab), Johnson & Johnson's Darzalex (daratumumab), and Bristol-Myers Squibb's Opdivo (nivolumab), and the sales of these three drugs have successfully exceeded the threshold of 10 billion US dollars. It is worth noting that except for Darzalex, the other four positions in the top five monoclonal antibodies are occupied by PD-(L)1 inhibitors.

In the field of small molecule drugs, AstraZeneca's Tagrisso (osimertinib), Astellas/Pfizer's Xtandi (enzalutamide), and Eli Lilly's Verzenio (abamacili) constitute the leading camp, with sales reaching US$6.58 billion, US$5.926 billion, and US$5.307 billion, respectively. However, due to the impact of the patent cliff, the sales of Imbruvica (ibrutinib) and Revlimid (lenalidomide) showed a continuous downward trend.

Three ADC drugs also made it into the TOP20 list, namely Enhertu (detrastuzumab) from AstraZeneca/Daiichi Sankyo, Kadcyla (enmetuzumab) from Roche, and Adcetris (vebrituximab) from Pfizer/Takeda. The total revenue of the three drugs reached US$7.946 billion, indicating the huge commercial potential of ADC therapy. Among them, Enhertu showed strong explosive power, with a 46% growth and sales of US$3.754 billion. Its indications have achieved full coverage of HER2-positive, HER2-low-expressing and HER2-ultra-low-expressing breast cancer.

In addition, a fusion protein drug also appeared on the list - BMS's Reblozyl (Rotecept). As the world's first red blood cell maturation agent, its annual sales reached US$1.773 billion, achieving a high growth rate of 70%. This achievement was mainly driven by the demand of patients with anemia caused by first-line myelodysplastic syndrome (MDS).

In addition to Reblozyl, the fastest growing product is BeiGene's Brukinsa (zabutinib). With its outstanding performance in defeating ibrutinib in head-to-head Phase III studies, it successfully advanced to the best in class molecule and quickly established a solid position in the market. Currently, Brukinsa has become the BTK inhibitor with the widest range of approved indications in the world, and is catching up with Calquence (aclotinib) with a strong expansion momentum, and has become the number one BTK inhibitor in the United States.

From the perspective of target competition, PD-(L)1 still maintains its absolute dominant position. This type of tumor immunotherapy has a very wide range of applications. For example, drug K has been approved for 49 indications in the United States and has become an indispensable and important treatment method in the treatment of various tumors.

From a company perspective, AstraZeneca's oncology business is growing rapidly, with strong performance of its core products providing strong support. BMS has made progress in both solid tumors and hematological tumors, building a huge product matrix.

Roche is accelerating the development of next-generation products based on the HER2 and PD-L1 fields. Merck has maintained a steady growth under the protection of K drug and actively expanded into areas such as ADC. Johnson & Johnson has established its leading position in the field of multiple myeloma with its rich "monoclonal antibody + bispecific antibody + CAR-T" product portfolio.

In general, the current oncology drug market is in a critical period of product iteration and technological innovation: traditional drugs with expired patents are accelerating their exit from the historical stage, while new treatment paradigms spawned by emerging technologies such as ADC are continuously reshaping the market competition landscape. As the strategic focus of major companies continues to tilt toward the next generation of oncology drugs, this treatment field may usher in more disruptive industrial changes in the future.

In the rapidly evolving field of oncology, several cancer drugs have become best-sellers due to their proven effectiveness against various cancer types. Below, we examine some of the top-selling cancer drugs, highlighting their FDA-approved indications, mechanisms of action, and sales figures.

1. Keytruda (Pembrolizumab) - $31 billion

Keytruda is the world's bestselling cancer drug by a large margin. (Merck & Co.)
Company: Merck & Co.
2024 sales: $29.5 billion

Indications Approved by FDA:

1. Melanoma, (KEYNOTE-006 and KEYNOTE-054 trials)
2. Non-small cell lung cancer, (KEYNOTE-010, KEYNOTE-407, KEYNOTE-189, KEYNOTE 671 trials)
3. head and neck cancer, (KEYNOTE-012 and KEYNOTE-048)
4. kidney cancer (renal cell carcinoma), (KEYNOTE-426)
5. classical Hodgkin lymphoma, (KEYNOTE-204)
6. primary mediastinal large B-cell lymphoma, 
7. bladder cancer, (EV-302/KEYNOTE-A39) 
8. microsatellite instability-high (MSI-H) or mismatch repair deficient cancers,
9. gastric cancer, 
10. esophageal cancer, 
11. cervical cancer, 
12. liver cancer, 
13. biliary tract cancer, 
14. Merkel cell carcinoma, 
15. endometrial cancer, 
16. tumor mutational burden-high cancer, 
17. cutaneous (skin) squamous cell carcinoma, 
18. Triple-negative breast cancer (TNBC). (ASCENT-04/KEYNOTE-D19 Study)

Keytruda (Pembrolizumab) remains the global leader in drug sales with projected revenues exceeding $31 billion in 2025. This cancer immunotherapy has expanded to over 40 approved indications since its launch in 2014, including multiple cancer types, driving strong sales growth.

In 2024, Merck's Keytruda (pembrolizumab) achieved global sales of approximately $29.5 billion, representing an 18% increase compared to 2023. Excluding foreign exchange impacts, the growth was about 22%. Keytruda remained the world’s best-selling drug, with multiple FDA approvals in 2024 expanding its indications, including treatments for cervical and endometrial cancers (1, 2, 3, 4, 6).

After AbbVie's Humira lost U.S. market exclusivity and as demand for COVID vaccines plummeted at the end of the pandemic, Merck & Co.’s Keytruda was finally able to claim the title of the world’s bestselling medicine in 2023. But its reign may be short-lived. 

In 2023, Keytruda’s sales grew 21% at constant exchange rates, reaching $25 billion. At the same time, as GLP-1 diabetes and obesity drugs take the world by storm, Novo Nordisk’s semaglutide franchise—Rybelsus, Ozempic and Wegovy—together generated 145.8 billion Danish kroner ($21.1 billion). That marked a nearly 90% surge over 2022. 

The three semaglutide brands continued their seemingly unstoppable growth into 2024. Their first-quarter sales collectively jumped 48% year over year to 42.2 billion Danish kroner ($6.1 billion), inching even closer to Keytruda’s $6.9 billion haul, which represented a 20% increase over the same period last year. 

Keytruda is no doubt the world's bestselling cancer drug. The next oncology asset on our list, Bristol Myers Squibb and Ono Pharma’s rival PD-1 inhibitor Opdivo, generated $10 billion last year. Johnson & Johnson recorded $9.7 billion for its anti-CD38 multiple myeloma drug Darzalex. 

Keytruda scored two high-profile FDA approvals last year, although one of them wasn’t specifically about the PD-1 drug itself. 

In October 2023, the FDA greenlighted Keytruda as part of a continued neoadjuvant-adjuvant therapy used around surgery in resectable non-small cell lung cancer, making it the first PD-1/L1 inhibitor regimen that’s used both before and after surgery. 

The approval was accompanied by phase 3 data from the KEYNOTE-671 trial showing that, compared with presurgical chemo alone, the addition of Keytruda around surgery significantly cut the risk of death by 28%. Despite perioperative Keytruda’s overall survival win, it remains unclear whether a checkpoint inhibitor is necessary both before and after surgery for all approved non-small cell lung cancer cases. The FDA has indicated it wants to tease out the exact contribution of each phase of treatment to the entire regimen. The ultimate length of treatment will affect Keytruda’s long-term sales potential.

In another major feat, a combination of Keytruda and Astellas and Pfizer’s Padcev won full FDA approval as a first-line treatment for advanced bladder cancer—regardless of the patient’s eligibility for chemotherapy. The approval came after the phase 3 EV-302 trial linked the Keytruda-Padcev combo to a 53% reduction in the risk of death compared with chemo. 

But the EV-302 readout was viewed as more of a success for Padcev and the antibody-drug conjugate modality, especially given Keytruda’s previous stumbles (Lancet Oncology 2021) in first-line bladder cancer as a monotherapy and as part of a combination with traditional chemotherapy. Nevertheless, the EV-302 regimen speaks to Keytruda’s appeal as the combination partner of choice for newer drugs. Another candidate taking that approach is Moderna and Merck’s individualized cancer vaccine, mRNA-4157 (V940). The shot’s cocktail with Keytruda has drawn much interest because of its promising midphase data in resected melanoma.  

However, not all attempts to pair Keytruda up have been successful. Some of the notable failures include Keytruda’s combos with AstraZeneca-partnered Lynparza and Eisai-shared Lenvima.

As Keytruda is slated to fall off the patent cliff in 2028, Merck has been working on a subcutaneous version to potentially soften the blow. However, Merck is behind its rivals BMS and Roche in terms of developing more convenient injections of their PD-1/L1 offerings. A dispute over a microscopic enzyme is threatening Merck & Co. plans to sell a new version of Keytruda, the cancer drug that generates nearly half of the company’s sales. Merck has been tweaking Keytruda to make it easier to use—and to protect billions of dollars in revenue the company could lose after U.S. patent protection runs out in 2028 and rivals can begin selling copycats. The enzyme in the new Keytruda allows it to be injected, rather than given intravenously. It is the subject of a brewing patent dispute between Merck and a biotech called Halozyme Therapeutics. (Wall Street Journal) 

While biosimilars for pembrolizumab are on the horizon, as of mid-2025 no biosimilar versions are yet widely available or approved for commercial use in key global markets. These drugs are biologics (monoclonal antibodies), which are complex to manufacture and subject to patent protections. Pembrolizumab’s patent (held by Merck) is expected to expire in the US around 2028, potentially allowing biosimilars (not generics, due to biologics’ complexity) to enter the market thereafter. Biosimilars are highly similar versions of biologics, requiring clinical trials to demonstrate equivalence, unlike small-molecule generics.

Some countries (e.g., India, China) may produce biosimilar or off-patent versions of ICIs, but these are not FDA- or EMA-approved and lack global standardization. For example, biosimilars for other biologics (e.g., rituximab) exist in India, but no specific pembrolizumab biosimilar is available in major markets.

The Biologics Price Competition and Innovation Act (BPCIA) grants a 12-year exclusivity period for original biologics in the US. Since Keytruda was first approved by the FDA on September 4, 2014, this exclusivity* is scheduled to expire on September 4, 2026 (Eureka). While this could theoretically allow for biosimilar applications, the stronger patent protections, which expire in 2028, are the main barrier to market entry.

*Note: Patent Protection vs Regulatory Exclusivity: Patent protection protects the inventor's intellectual property, including the drug molecule itself and its manufacturing process. Regulatory exclusivity prevents competitor products from entering the market, regardless of patent status. This is distinct from patents and applies to biologic drugs like Keytruda.

Update (May 2025): KEYTRUDA® (pembrolizumab) Plus Trodelvy® (sacituzumab govitecan-hziy) Reduced Risk of Disease Progression or Death by 35% Versus KEYTRUDA Plus Chemotherapy in First-Line PD-L1+ Metastatic Triple-Negative Breast Cancer (TNBC) (ASCENT-04/KEYNOTE-D19 Study)

2. Darzalex (Daratumumab) - $11.6 billion

Indication Approved by FDA: Multiple myeloma and light chain amyloidosis.

Mechanism of Action: Darzalex is a monoclonal antibody that targets CD38, a glycoprotein expressed on the surface of multiple myeloma cells. By binding to CD38, Darzalex induces tumor cell death through multiple mechanisms, including complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity, and antibody-dependent cellular phagocytosis. It also modulates the immune system to attack the cancer cells.

Company: Johnson & Johnson
2023 sales: $9.7 billion

2024 sales: $11.6 billion

Johnson & Johnson achieved (Q2 2025 Results) its highest quarterly growth figure since the fourth quarter of 2023, making a 6% gain in the second quarter behind its oncology portfolio, which achieved 24% growth. The standouts were multiple myeloma drug Darzalex, which was up 23% to $3.5 billion.

The Darzalex franchise, including the subcutaneous formulation Darzalex Faspro, was Johnson & Johnson’s second-largest brand last year. With $9.74 billion in global sales, the multiple myeloma drug accounted for 11.4% of the pharma and medtech giant’s total revenue haul for the year. 

Darzalex secured its initial FDA approval in 2015 as a fourth-line multiple myeloma treatment and the first monoclonal antibody for the blood cancer. It entered the first-line setting in 2018 as part of a now outdated combination including Takeda’s Velcade, the alkylating agent melphalan and the corticosteroid prednisone.   

Much more recently, the J&J drug has shown promise as part of an advanced combo with Velcade, Bristol Myers Squibb’s Revlimid and the steroid dexamethasone (VRd). Late last year, the Darzalex-containing four-drug regimen showed it could slash the risk of progression or death by 58% versus VRd alone in first-line myeloma patients who’re eligible for stem cell transplants. The company filed that combo with the FDA in January and secured a priority review. 

3. Opdivo (Nivolumab) - $7 billion

Indications Approved by FDA:

• NSCLC
• Melanoma
• RCC
• HNSCC
• Urothelial carcinoma
• Classical Hodgkin lymphoma
• Hepatocellular carcinoma
• Esophageal squamous cell carcinoma
• Gastric cancer
• Colorectal cancer with MSI-H/dMMR
• Small cell lung cancer (SCLC)

Mechanism of Action: Opdivo is another immune checkpoint inhibitor that targets the PD-1 receptor on T cells. Like Keytruda, it blocks the PD-1/PD-L1 interaction, enhancing the immune system's ability to recognize and destroy cancer cells.

Companies: Bristol Myers Squibb and Ono Pharmaceutical
2023 sales: $10 billion

2024 sales: $9.3 billion

Bristol Myers Squibb (BMY) and Ono Pharmaceutical’s Opdivo, a treatment for melanoma and other cancers, generated $9.3 billion in global sales. In 2024, the melanoma-fighting medication alone accounted for nearly 20% of the company’s $48.3 billion in annual revenue.

Opdivo generated $10 billion in global sales last year, with $9 billion going to Bristol Myers Squibb and 148 billion Japanese yen ($1 billion) going to Ono Pharmaceutical.

4. Tagrisso (Osimertinib) - $5 billion

Indications Approved by FDA: 

• EGFR T790M mutation-positive NSCLC
• First-line treatment of metastatic NSCLC with EGFR exon 19 deletions or exon 21 L858R mutations

Mechanism of Action: Tagrisso is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). It selectively inhibits both EGFR sensitizing mutations and the T790M resistance mutation, which is a common cause of resistance to earlier-generation EGFR TKIs. By blocking these mutations, Tagrisso inhibits cancer cell proliferation and induces apoptosis.

5. Revlimid (Lenalidomide) - $5.7 billion

Indications Approved by FDA:

• Multiple myeloma
• Mantle cell lymphoma
• Myelodysplastic syndromes (MDS)
• Follicular lymphoma

Mechanism of Action: Revlimid is an immunomodulatory drug that has multiple mechanisms of action, including direct anti-proliferative effects on tumor cells, inhibition of angiogenesis, and immune system modulation. It also enhances T-cell and natural killer (NK) cell-mediated cytotoxicity and reduces the production of pro-inflammatory cytokines.

6. Verzenio (Abemaciclib) - $4 billion

Indications Approved by FDA: HR-positive, HER2-negative advanced or metastatic breast cancer

Mechanism of Action: Verzenio is an oral, selective inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6). By inhibiting CDK4/6, Verzenio prevents the phosphorylation of the retinoblastoma protein (Rb), leading to cell cycle arrest at the G1 phase, thereby inhibiting the proliferation of cancer cells.

7. Imfinzi (Durvalumab) - $4.7 billion

Indications Approved by FDA:

• Unresectable stage III NSCLC
• Extensive-stage small cell lung cancer (ES-SCLC)
• Urothelial carcinoma

Mechanism of Action: Imfinzi is a monoclonal antibody that targets PD-L1, a ligand for PD-1. By binding to PD-L1, Imfinzi prevents it from interacting with PD-1 on T cells, thereby restoring immune responses and allowing the immune system to attack the cancer.

8. Ibrance (Palbociclib) - $4.3 billion

Indications Approved by FDA: HR-positive, HER2-negative advanced or metastatic breast cancer

Mechanism of Action: Ibrance is an oral CDK4/6 inhibitor, similar to Verzenio. It works by inhibiting CDK4/6, which leads to cell cycle arrest in the G1 phase. This action reduces cancer cell proliferation, particularly in HR-positive breast cancer.

9. Perjeta (Pertuzumab) - $4.1 billion

Indications Approved by FDA: HER2-positive breast cancer

Mechanism of Action: Perjeta is a monoclonal antibody that targets the HER2 receptor, a protein that is overexpressed in some breast cancers. Perjeta binds to a different epitope on HER2 than Herceptin (trastuzumab), allowing for a more comprehensive blockade of HER2 signaling. This dual inhibition results in a more potent suppression of tumor growth.

10. Tecentriq (Atezolizumab) - $4.1 billion

Indications Approved by FDA:

• NSCLC
• SCLC
• Urothelial carcinoma
• Triple-negative breast cancer (TNBC)
• Hepatocellular carcinoma (HCC)

Mechanism of Action: Tecentriq is a monoclonal antibody that targets PD-L1, similar to Imfinzi. By blocking the PD-L1/PD-1 interaction, Tecentriq reactivates T cells to detect and destroy cancer cells.

Company: Roche

To fill the sales growth void, Roche is looking in part to immuno-oncology product Tecentriq (checkpoint inhibitor), which currently bears approvals in lung cancer and bladder cancer. There’s just one problem: Its rivals do, too, and analysts say Roche’s data doesn’t seem to stack up to competitor Merck’s in the all-important front-line lung cancer market.

That’s not to say the drug can’t find other markets to control, and recently, trial wins have hinted that Tecentriq may just find some key niches.

Roche is also looking to find new sales avenues for its older drugs through combinations. It’s paired Tecentriq and Avastin in areas such as lung cancer and liver cancer, and it won an FDA approval for a combination of Herceptin and newer breast cancer treatment Perjeta in postsurgery patients, despite data that analysts labeled “weak.”

11. Imbruvica (Ibrutinib)

• Company: AbbVie
• Indication: Chronic lymphocytic leukemia
• Main Indication/Subtype: BTK
• Details: CLL/SLL, MCL, GVHD
• 2024 Sales: 6.3B
• Growth: -6.9%

12. Xtandi (Enzalutamide)

• Company: Pfizer
• Indication: Prostate cancer
• Main Indication/Subtype: AR
• Details: Prostate cancer
• 2024 Sales: 5.9B
• Growth: 16.9%

13. Verzenio (Abemaciclib)

• Company: Eli Lilly
• Indication: Breast cancer
• Main Indication/Subtype: CDK4/6
• Details: Breast cancer
• 2024 Sales: 5.3B
• Growth: 37.4%

14. Jakafi (Ruxolitinib)

• Company: Incyte/Novartis
• Indication: Myelofibrosis
• Main Indication/Subtype: JAK1/2
• Details: Myelofibrosis, Polycythemia vera, Graft-versus-host disease, etc.
• 2024 Sales: 4.7B
• Growth: 9.6%

15. Enhertu (Fam-trastuzumab deruxtecan)

• Company: Daiichi Sankyo/AstraZeneca
• Indication: HER2-positive Breast cancer
• Main Indication/Subtype: HER2
• Details: Breast cancer, Gastric cancer
• 2024 Sales: 3.7B
• Growth: 46.0%

16. Lynparza (Olaparib)

• Company: AstraZeneca/Merck & Co.
• Indication: Ovarian cancer/Breast cancer
• Main Indication/Subtype: PARP1/2
• Details: Ovarian cancer, Breast cancer, etc.
• 2024 Sales: 3.6B
• Growth: 20.0%

17. Pomalyst/Imnovid (Pomalidomide)

• Company: Bristol-Myers Squibb
• Indication: Multiple myeloma
• Main Indication/Subtype: CRBN/IKZF1/3
• Details: Multiple myeloma
• 2024 Sales: 3.5B
• Growth: 3.0%

18. Calquence (Acalabrutinib)

• Company: AstraZeneca
• Indication: Chronic lymphocytic leukemia
• Main Indication/Subtype: BTK
• Details: Mantle cell lymphoma, CLL/SLL, DLBCL
• 2024 Sales: 3.1B
• Growth: 24.0%

19. Kisqali (Ribociclib)

• Company: Novartis
• Indication: Breast cancer
• Main Indication/Subtype: CDK4/6
• Details: Breast cancer
• 2024 Sales: 3.0B
• Growth: 45.9%

20. Erleada (Apalutamide)

• Company: Johnson & Johnson
• Indication: Prostate cancer
• Main Indication/Subtype: AR
• Details: Prostate cancer
• 2024 Sales: 2.9B
• Growth: 25.6%

Sources:

1. https://www.ipharmacenter.com/post/top-selling-cancer-drugs-of-2024-best-selling-cancer-drugs-top-cancer-drugs-by-revenues-in-2024
2. Top 10 Cancer Drug Companies of 2025
3. Top 10 Drugs by Worldwide Sales in 2024
4. https://inf.news/en/health/424074cef1935da2e7db8d801641eae0.html

Disclaimer

The information presented in this article, is intended for general informational purposes only and should not be construed as professional financial, investment, or medical advice. The revenue figures, company rankings, and projections are based on publicly available data, company reports, and industry estimates as of 2025. All currency conversions, where applicable, are based on annual average exchange rates, and revenues outside the health sciences sector have been excluded for consistency (1).

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